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The Food and Drug Administration's (FDA's) 510(k) Process: A Systematic Review of 1000 Cases
General Surgery
  • Puja Shah, McGovern Medical School
  • Oscar Olavarria, McGovern Medical School
  • Naila Dhanani, McGovern Medical School
  • Hailie Ciomperlik, McGovern Medical School
  • Cassandra Mohr, McGovern Medical School
  • Karla Bernardi, McGovern Medical School
  • Niharika Neela, McGovern Medical School
  • Rainna Coelho, HCA Healthcare
  • Zuhair Ali, HCA Healthcare
  • Ajita Prabhu, Cleveland Clinic
  • Mike K Liang, HCA Healthcare
Division
Gulf Coast
Hospital
HCA Houston Healthcare Kingwood
Document Type
Manuscript
Publication Date
9-25-2022
Keywords
  • 510k process,
  • FDA,
  • conflict of interest,
  • devices,
  • recall,
  • systematic review
Abstract

BACKGROUND: The vast majority of devices cleared by the Food and Drug Administration (FDA) are through the 510(k) process which allows medical devices to be quickly introduced into the market. FDA 510(k) process is designed to minimize the burden and expense of bringing new devices to market, however as a result may be limited in its ability to establish the safety of these devices.

METHODS: The FDA 510(k) online archives were searched for devices cleared from 2013-2014. One thousand devices were randomly selected. PubMed was searched for each device to identify publications regarding the devices. Primary outcome was the percentage of devices cleared through the 510(k) process with no published research. Secondary outcomes included: conflict of interest (COI) of authors and outcomes of published studies on the devices.

RESULTS: A total of 6152 devices were cleared through the 510(k) process from 2013-2014. Of the 1000 randomly selected devices, 17.8% had published research. There were 375 manuscripts, of which 47 (12.5%) were randomized controlled trials. One-fourth (25.1%) of studies had a clearly identifiable COI, while COI was unclear for half (49.9%).

CONCLUSION AND RELEVANCE: There is limited evidence examining the safety and effectiveness of devices cleared via the 510(k) process. Thousands of devices are cleared through the FDA's 510(k) process each year with limited or no evidence publicly available. This has led to the market being introduced with potentially costly, non-beneficial, or harmful devices. Devices, like prescription drugs, should undergo a more rigorous clearance process.

Publisher or Conference
The American Journal of Medicine
Citation Information
Shah P, Olavarria O, Dhanani N, et al. The Food and Drug Administration's (FDA's) 510(k) Process: A Systematic Review of 1000 Cases. Am J Med. 2023;136(2):172-178.e14. doi:10.1016/j.amjmed.2022.09.006